Health Affairs, doi: 10.1377/hlthaff.28.4.w566 (Published online May 21, 2009) © 2009 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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Hospital Quality And Intensity Of Spending: Is There An Association?

¹ Laura Yasaitis is a student in the joint MD/PhD program at Dartmouth Medical School, in Hanover, New Hampshire.
² Elliott Fisher is director of the Center for Healthcare Research and Reform, Dartmouth Institute for Health Policy and Clinical Practice.
³ Jon Skinner is a professor at Dartmouth College, and at the Dartmouth Institute.
⁴ Amitabh Chandra is a professor in the Kennedy School of Government, Harvard University, in Cambridge, Massachusetts, and a fellow at the Dartmouth Institute.

^*Corresponding author.

Abstract

Numerous studies in the United States have examined the association between quality and spending at the regional level. In this paper we evaluate this relationship at the level of individual hospitals, which are a more natural unit of analysis for reporting on and improving accountability. For all of the quality indicators studied, the association with spending is either nil or negative. The absence of positive correlations suggests that some institutions achieve exemplary performance on quality measures in settings that feature lower intensity of care. This finding highlights the need for reporting information on both quality and spending. [Health Affairs 28, no. 4 (2009): w566-w572 (published online 21 May 2009; 10.1377/hlthaff.28.4.w566)]

Key Words: Business Of Health, Consumer Issues, Health Reform, Hospitals, Health Spending, Quality Of Care, Variations

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